Amudipes Outpatient Services

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

AMUDIPES OUTPATIENT SERVICES

Practice address

5111 Dolphin LN
Charlotte, NC 28215-3101

Phone

(704) 531-0359

NPI assigned

Jan 11, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ellen Amudipe

Title

Owner

Phone

(215) 858-7685

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1294704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296172800000",
    "number": "1922303601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 NORRISTOWN RD",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194222802",
            "telephone_number": "215-858-7685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5111 DOLPHIN LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282153101",
            "telephone_number": "704-531-0359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMUDIPES OUTPATIENT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-11",
        "last_updated": "2011-01-28",
        "status": "A",
        "authorized_official_last_name": "AMUDIPE",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-858-7685"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.